Claim for Motor Vehicle Refund
PS2511-19 (11/19)
Name
MINNESOTA DEPARTMENT OF PUBLIC SAFETY
DRIVER AND VEHICLE SERVICES
445 Minnesota St. Ste 162
St. Paul, Minnesota 55101-5162
(651) 296-0118 TTY (651) 282-6555
dvs.dps.mn.gov
Address (Street number, R.F.D., City, State, Zip Code
Registration Plate Number Registration Sticker Number
Signature
DOUBLE REGISTRATION
DEPUTY REGISTRAR STAMP
PART A: GENERAL INFORMATION (Complete in all cases)
Year Vehicle Identification Number (VIN)
I affirm that all statements in this application are true and correct and in accordance with provisions of law, and hereby makes application for
refund of type of tax and on such vehicle as herein described.
Date
PART B: REGISTRATION TAX
Sticker # on vehicle Sticker # returned
If stickers are returned used, provide license plate number of vehicle they were used on
VEHICLE PERMANENTLY DESTROYED (Check one)
Accident Fire Flood Tornado
NOTE: Current plates/stickers and title MUST accompany claim or no refund is due.
Name
REGISTRATION IN ERROR, PAID TAX AFTER VEHICLE SOLD TO
Street address City
State Zip Code
Date
If stickers are returned used, provide license plate number of vehicle they were used on
To ClassFrom Class
CONVERSION TO LOWER CLASS:
Date of conversion
PART C: SALES TAX
Net purchase price $
OVERPAYMENT
Explain below in PART D
(see reverse side)
CLAIM EXEMPTION NUMBER
Explain below in PART D
$
CLAIM CREDIT OF
Motor vehicle sales tax paid to state of
PART D: OTHER
EXPLANATION:
PART E: CERTIFICATION
PART F: APPROVAL
NOTE: Must show proof of payment to other state, such as validated receipt.
Have plates/stickers been
returned?
Has registration card/title been
returned?
Have plates/stickers been used?
Date approved Approved by:
Amount of refund Refund to:
Address:Refund check made payable to:
Print Form
PS2511-19 (11/19)
Claim for Motor Vehicle Refund
PART A:
INSTRUCTIONS
Complete name and address, and appropriate vehicle information for which a refund of taxes or fees is requested.
If a refund of registration taxes is requested for reason of gross weight reduction or class change resulting in lower
tax liability of a truck, tractor, truck-tractor, or trailer, indicate by checking the appropriate box the reason for the gross
weight or class reduction and give all required information for the item checked.
If a refund of registration tax is requested for a passenger vehicle, indicate by checking the appropriate box the
reason for the refund request, and give all required information for the item checked.
If a registration tax was paid on a vehicle that was previously sold, please submit a copy of the proof of sale (i.e.
purchase agreement; bill of sale).
PART B:
PART C:
If a refund of the Motor Vehicle Sales Tax is requested, check the appropriate box and indicate the reason for
refund, giving all required information for the item checked. If an exemption is claimed, enter in the space
provided the appropriate number corresponding with the following exemptions:
1. Vehicle was a gift between individuals: Vehicle was a transfer between husband and wife in a divorce
proceeding: Indicate “Divorce”.
2. Vehicle was acquired by inheritance, bequest, or by selection by surviving spouse.
3. Vehicle is for sale by purchaser who holds sales and use tax account number:
This applies to lending institutions and insurance companies only.
4. Vehicle was transferred from joint ownership to ownership by one or more of the same joint owners
without monetary consideration. Vehicle transfer was covered by an internal revenue code.
Provide Internal Revenue Code #:
5. Purchaser was a nonresident when the vehicle was purchased and subsequently became a resident of
Minnesota more than 60 days after the date the vehicle was titled in another state.
6. The purchaser is a disabled veteran purchasing with funds provided by the Veterans Administration
under the provisions of Title 38. VA authorization letter must accompany this form.
7. Purchaser is an interstate carrier holding a common carrier direct pay certificate. Prorate vehicles only.
Provide number:
8. Vehicle is for resale or lease by a licensed Minnesota dealer or lessor who has a Minnesota dealer’s
license number. Provide number:
9. Purchase of a motor vehicle by a private nonprofit or public educational institution for use as an
instructional aid in automotive training programs operated by the institution.
10. The vehicle is a municipal fire apparatus, marked police car, municipal ambulance, the general
appearance of which is an unmistakable purchase of an ambulance by a licensed ambulance service.
11. The purchaser is a federal government agency or instrumentality.
12. Vehicle was registered with Y-class, instate plates but needed apportioned, prorated plates.
Should be used for all other refunds that are not listed.
PART D:
FOR OFFICE USE ONLY.
PART E and F:
The amount of excise tax incorrectly paid by the applicant, the registration tax paid on a vehicle not in use for the entire
registration period, or registration tax paid in full a second time on the same vehicle will be refunded if approved. Vehicles
removed from state must return plates and/or stickers before the new registration period begins to receive a refund.
For all other approved refunds, the amount of refund is computed beginning with the month after the month in which the plates/
stickers are returned to the Driver and Vehicle Services Division or to a Deputy Registrar, or a gross weight is reduced.
The following are not refundable: Duplicate plate fees, registration on a worn-out vehicle, and the filing fee authorized
by Minnesota Statutes for each processed application.
GENERAL INFORMATION